2021 outlook for hospitals, health systems, and medical professionals

By Tina Wheeler, Health Care sector leader, Deloitte, LLP

My daughter Katie is in the middle of her second year of medical school. She spent her first year scuttling between classrooms and labs all around the campus. Since March, however, most of her medical training has taken place in her home office. The pandemic has changed the way we all work, but it also has impacted the way students learn—even in medical school. The medical students who emerge from this pandemic as clinicians will likely meet patients with a new set of tools and a unique perspective on disease prevention and public health. I expect Deloitte’s vision for the Future of Health^TM will continue to play out in significant ways during 2021 and the years that follow. 

Recent research from the Deloitte Center for Health Solutions explores both the Physician of the Future and the Hospital of the Future and what we expect to see in the years ahead. Here is a look at some of the trends I expect will emerge or accelerate in the health ecosystem with specific impact on hospitals, health systems, clinicians, and health plans: 

• A wave of white coats could help offset anticipated physician shortages: Hospitals and health systems have been experiencing staffing shortages over the past two decades.As the COVID-19 pandemic surged last fall, hospitals in at least 25 states were critically short of nurses, doctors, and other staff, according to the American Hospital Association. By 2033, the US could face a shortage of between 54,100 and 139,000 physicians, according to a June 2020 report from the Association of American Medical Colleges (AAMC).¹ The anticipated shortage, the report concludes, will be driven by a large percentage of physicians who are nearing retirement age. Since the pandemic began, however, medical schools have seen an average 18% increase in applicants, according to AAMC. Nursing schools report a 6% increase in applications.² Interest in practicing medicine and helping others might be tied to the example set by high-profile public health figures including Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. I expect this increased interest in medicine as a career will continue as young people look for ways to give back during a time of need.
• Future medical professionals could be more interested in public health: Many students who enrolled in medical school this year were inspired by the pandemic to make a difference. Several years from now, the COVID-19-generation of medical professions might be more interested in public health than were prior generations. Some medical schools have already added electives that offer students more opportunities to work with public health organizations.³ These new medical professions could also enter the workforce with a heightened awareness of health inequities, systemic racism, and the drivers of health (e.g., healthy food, adequate housing, well-paying jobs, safe environment).
• Reliance on virtual health will likely grow: Before the pandemic, Katie’s Art and Practice of Medicine (APM) class focused on teaching physical-exam skills. Each week, students were taught how to interview standardized patients in hospital exam rooms. Last spring, in response to the pandemic, those face-to-face encounters moved to an online platform where students learned a new set of web-side manners. This is a skill that physicians will likely need in the future as more care is delivered virtually. One tip she learned in APM is to use the ‘spotlight’ mode in her computer settings so that it appears to the patient that she is making eye-contact (rather than staring at the screen). Students have also been advised not to type notes while talking with a patient because the clicking noise can be distracting.
• More hospital-level care could be delivered in the home: The idea of providing hospital-level care in the patient’s home has gained traction among providers and payers over the past year as COVID-19 demonstrated how quickly a hospital can reach capacity in some hotspot areas. As my colleague Summer Knight explained in her blog last summer, hospital at home is the concept of identifying people who are candidates for admission to the hospital and admitting them to their home where they receive the same level of quality, acute care. 
• Transparent pricing could help educate and empower consumers: For health plans, hospitals, and health systems in 2021 these newly engaged digital consumers will likely have even greater influence in many aspects of the health ecosystem. The mandates around greater price transparency for drugs and hospital costs—pushed by, or at least inspired by, consumers—went into effect on January 1. (See the details here.)  While we have seen some inconsistency in adoption thus far, the opportunity is there. A well-designed digital front door can provide a personalized cost estimate, financing terms, and an option to schedule the encounter during the same digital interaction. That can translate into better financial outcomes for the provider and a better service experience for the patient. The new rules are creating mandates and opportunities for greater data-sharing in the industry. Health plans might find opportunities for collaboration by investing in targeted initiatives and capabilities for improving the drivers of health (also referred to as social determinants) or around care management for people who have chronic conditions.
• Interoperability will change interactions between ecosystem players: A more interoperable ecosystem will likely be easier for consumers to navigate. The new rules went into effect on January 1 for providers. Health plans do not have to adopt the transparency rules until January 1, 2022. This will give them a full year to understand how data sharing could help health plans empower and guide members and enhance the quality of their health journey. The net effect of these changes is that there could be significant opportunities for stakeholders to evaluate the data elements that have been made more accessible and analyze how this data can be used to improve care delivery and the individual experience.

With all of this in mind, I think back to Katie as she begins her clinical training next summer, working directly with patients. The experiences she shared with her classmates during the pandemic, as well as the experiences of clinicians and other care providers, will likely have a profound impact on the way medicine is practiced in the years and decades ahead. The physician-patient relationship will also change as patients gain access to detailed pricing information and gain control over their health data. How the system adapts to these changes will determine the course and career of future clinicians like Katie, her patients, and the health ecosystem that serves them.

Endnotes:

^{1. US physician shortage is growing, Association of American Medical Colleges, June 26, 2020}

^{2. Silver lining of 2020: Medical and nursing schools see increase in applications, The Today Show/Today.com, December 22, 2020}

^{3. Public health pathways for medical students, American Association of Medical Colleges} 

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